'Life Science University Krems' - implementing Bologna in the medical education: a proposal

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The Structure of Medical Education in Europe: Implementing Bologna – On the way to a European success story?.
International Conference hosted by the German Rectors’ Conference (HRK).
Berlin,
10.-11.10.2008.
DÃ¼sseldorf: German Medical Science GMS Publishing House; 2011. Doc08hrk15

Gliederung

Introduction: Recently, the Government of Lower Austria decided to establish a new university on life science with emphasis on medicine. One of the major driving forces for this decision is the fact that Lower Austria, although being the largest state in Austria, does not have a regular university, but only a college for continued education and several institutes for applied science which offer application-oriented studies only.

Under Austrian federal law only the federal government is authorized to establish public universities, all others will be private. Furthermore, all private universities have to undergo an accreditation, where the Bologna Process is evident thus giving the opportunity to discuss new ideas about the medical education.

Medical Studies: In Austria as well as in most European countries, curricula require at least six years or 5,500 hours of theoretical and practical work at a university or under the supervision of a university. After finishing the required studies at the university, regulations for further education and training differ in the countries of the European Union. In Austria, an additional 3- to 6-year cycle, a so-called ‘Turnus’ has to be performed at a university hospital or a medical consulting facility with a teaching license. If the three-year cycle is chosen, students get the ‘Approbation’ (license to practice medicine) and are allowed to work as medical doctors (‘Allgemeinmediziner’). The six-year cycle leads to the ‘Facharzt fÃ¼r …’ (specialist in …).

Prerequisite to enter the curriculum is 12 or 13 years of education at primary and secondary school levels with the ‘Abitur’ as final degree. For students who do not wish to work as physicians but rather as medical scientists and researchers or in related scientific fields like biomedicine, medical technique, medical information technology as well as hospital and/or nursing management or health care management, etc, the actual situation results in an unreasonably length of study. Such students have to satisfy all the actual requirements of the curriculum – which are six years of undergraduate study followed by at least a 3-year ‘Turnus’ – to get the academic medical degree even though they will never work as practicing physicians.

To ameliorate such an unsatisfactory situation, the Life Science University Krems proposes the idea of dividing the medical curriculum into two separate sections, a theoretical part, which after three years of successful study confers the degree of ‘Bachelor of Medicine’ and an extended clinical part, requiring an additional three years of study with the final degree of ‘Master of Medicine’ and, in combination with a thesis, the ‘Dr.med.univ.’ (doctor medicinae universae) which is the standard final degree at Austrian medical schools. To ensure that students in the Bachelor part also achieve knowledge about hospital-work, project work and short clinical phases are incorporated.

If students complete both parts, the content of their study programme will fulfil all the EU requirements and be identical to the programmes offered at public Austrian medical schools. The students then can enter the usual educational and training programmes to get their ‘Approbation' at the end.

Students who finish only the first, the Bachelor part may transfer to related technical, socio-economic or management studies, lasting two to three years, and finish with an appropriate Master Degree. Nevertheless, it is worth noting that these students will not be allowed to work as physicians, as they will not have attained the Master of Medicine, a required prerequisite.

Figure 1 [Fig.Â 1] shows a scheme of the medical Bachelor curriculum and the ensuing Master programmes offered at the Life Science University Krems (LSU). It should be noted again that the medical track (Bachelor of Medicine and the consecutive Master of Medicine) is the only way to become a physician. As mentioned above, students have to write a thesis to earn the final degree ‘Dr.med.univ.’ before entering the ‘Turnus’, after which they may be licensed to work as physicians (‘Approbation’).

Students of the first cycle would not only be confronted with the core medical curriculum, but also with many electives that help qualify them for immediate employment as well as to pursue other Master studies. These facts, especially the employability of the Bachelor, prompt an appropriate curriculum.

Bachelor of Medicine: Based on the qualifications of a Bachelor of Medicine, the question to answer was ‘what does a Bachelor of Medicine really have to know’ to equip them with adequate knowledge for continuing she/her studies or employment.

Additional to all subjects, who are common for undergraduate medical curricula, graduates from LSU will acquire substantial insight in the various fields of health care, management, medical informatics as well as how the Austrian health system functions. Students will also take part in a clinical training and introductory lectures about the main clinical subjects.

All subjects are arranged in four didactic blocks. They are put together according to their content and coordinated with each other based on a system of prerequisites. The Bachelor of Medicine Degree can be achieved after three years, having been awarded with 180 ETCS credits.

Master of Medicine: Students, who want to become medical doctors, have to enrol in the Master of Medicine programme. The concept of LSU has as goal to give its students a thorough clinical education by confronting them to a broad diversity of patients and diseases. The Master programme consists of rotations covering the clinical fields. Each rotation consists of a lecture part and its clinical integration. To achieve an effective clinical experience, students will be divided into small groups with a maximum of seven per group. After three years and having gained 180 ETCS credits, the students will be promoted to Doctor of Medicine (‘Dr.med.univ.’) which is the regular final degree for medical studies in Austria. It is worthy to notice that this Austria specific degree is a diploma degree and not equal to a PhD Degree.

The concept of the Life Science University Krems foresees to implement the Bachelor/Master programme into its medical education. It aims to achieve that the degree is completed within six years, not only on paper but also in reality. Although this may mean no shortening of study time, LSU students may in contrast to studies at a public Austrian university be sure to finish their studies in time. However, shortening could be realized easily by reduction of the term breaks and to increase student’s work load from about 1,500 hrs per year, as it is the actual number in Austria, to about 2,000 hrs which means about 45 hrs per week with 7 weeks per year vacation.

Additionally it should be noted that previous considerations were based on a five year curriculum but the EU directives on the recognition of professional qualifications requires a 6-year medical study programme. Therefore, LSU shifted to 3-year Bachelor and 3-year Master programmes. Figure 2 [Fig.Â 2] gives an overview on the concept of the medical curriculum at Life Science University Krems.

LSU is quite sure that the presented Bachelor/Master structure takes up the challenges of modern medical education and opens a way to its future.